Successful reconstruction after radical resection of arteriovenous malformation of the finger and toe using microsurgery

AbstractThis report presents two cases of arteriovenous malformation of the finger and toe. In case 1, a diffuse arteriovenous malformation of the second toe was resected completely. As a result of radical resection, blood circulation to the second toe was ablated. To preserve the second toe, vein grafting from the forearm region was performed using a microsurgical technique. Using this procedure, complete preservation of the second toe was performed. In case 2, a diffuse arteriovenous malformation of the middle finger was resected completely and successful reconstruction was performed using a sensate free radial forearm flap transfer. One year after the operation, there has been no recurrence of the disease, and the functional result was acceptable. Radical excision for the arteriovenous malformation was recommended to avoid the recurrence of the disease. We believe that the microsurgical technique, including free flap transfer and vein grafting, enables radical excision and decreases postoperative morbidity

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Progress report for intractable ulcer and osteomyelitis cases using autologous micrografts

Intractable ulcers often occur following primary diseases and have a significant impact on the quality of life of affected subjects. The medical treatments now available include compression and continuous debridement or additional interventions such as advanced wound dressings, local or systemic antibiotics with a mild benefit for the patients in the long term. In this report, we describe the use of autologous micrografts obtained by Rigenera ® procedure in the management of two cases of intractable ulcers showing good outcomes for both patients approximately after 30 days from intervention. In the first case, a 74-year-old male with a diagnosis of Fournier’s gangrene who underwent several interventions showed a rapid wound epithelization after micrografts application. In the second case, a 63-year-old male affected by a left hallux ulcer with a diagnosis of chronic osteomyelitis also showed a gradual reduction in the ulcer approximately after 1 month from micrografts application

Charade of the SR K+-Channel: Two Ion-Channels, TRIC-A and TRIC-B, Masquerade as a Single K+-Channel

The presence of a sarcoplasmic reticulum (SR) K+-selective ion-channel has been known for >30 years yet the molecular identity of this channel has remained a mystery. Recently, an SR trimeric intracellular cation channel (TRIC-A) was identified but it did not exhibit all expected characteristics of the SR K+-channel. We show that a related SR protein, TRIC-B, also behaves as a cation-selective ion-channel. Comparison of the single-channel properties of purified TRIC-A and TRIC-B in symmetrical 210 mM K+ solutions, show that TRIC-B has a single-channel conductance of 138 pS with subconductance levels of 59 and 35 pS, whereas TRIC-A exhibits full- and subconductance open states of 192 and 129 pS respectively. We suggest that the K+-current fluctuations observed after incorporating cardiac or skeletal SR into bilayers, can be explained by the gating of both TRIC-A and TRIC-B channels suggesting that the SR K+-channel is not a single, distinct entity. Importantly, TRIC-A is regulated strongly by trans-membrane voltage whereas TRIC-B is activated primarily by micromolar cytosolic Ca2+ and inhibited by luminal Ca2+. Thus, TRIC-A and TRIC-B channels are regulated by different mechanisms, thereby providing maximum flexibility and scope for facilitating monovalent cation flux across the SR membrane